Can You Rebuild Your Balance After 70?

In 2018, 28.5 percent of adults aged 75 to 84 who lived at home reported a fall in the past year (opens in a new tab), and among adults 85 or older the figure was 33.8 percent. Numbers like that make it easy to assume that balance lost after 70 is gone for good. But falling doesn't need to be a normal part of aging, and balance that has slipped can improve with practice.

In fact, balance can improve with training at 70, 80 and older. In a trial of women 80 and older who lived at home, balance improved over six months in the group that followed a strength and balance program built for each of them. Just as important, the program reduced falls and injuries.

Sudden trouble walking, dizziness, loss of balance or lack of coordination can be signs of a stroke (opens in a new tab), so call 911 right away. If you've fallen or almost fallen, tell your doctor; the other warning signs and what to do after a fall are in the section on sudden unsteadiness and falls.

What research on exercise in older adults found

One large review combined 108 exercise trials with participants who averaged 76 years old and looked at how often they fell. Exercise reduced the rate of falls by 23 percent (opens in a new tab). Balance and functional exercises, the kind built around the movements of daily life, reduced the rate by 24 percent, and 13 percent fewer people who did them fell at all.

A second review looked at balance itself and found that several kinds of exercise moderately improved scores on balance tests taken right after the programs ended. The kinds that helped included walking practice, balance and coordination work, everyday tasks, strengthening, tai chi, dance or yoga, and mixes of these.

Strength can still be built late in life. In a 10-week trial of strength training with frail nursing home residents aged 72 to 98, muscle strength more than doubled in the people who exercised, and their walking speed rose by about 12 percent.

What exercise can work on, and what belongs to your doctor

As you get older, your eyesight, hearing and reflexes may not be as sharp as they once were. Loss of muscle mass with age (called sarcopenia), problems with balance and walking, and blood pressure that drops too much when you get up from lying down or sitting are all risk factors for falling. Certain medicines, infections and problems with blood circulation can also cause balance problems.

Strength, balance and walking are things exercise can work on. Vision, hearing, medicines and blood pressure are for your doctor, so a good plan includes both.

Fear of falling has a cost of its own. Many older adults fear falling even if they've never fallen, and that fear can lead them to avoid walking, shopping or social activities. If you've noticed a parent turning down outings they used to enjoy, this may be part of the reason. But staying active keeps your body healthy and helps prevent falls.

Set aside time for balance practice about three times a week

In the balance review we mentioned earlier, the more effective programs ran three times a week for three months (opens in a new tab) and had people practicing on their feet and moving. That lines up with the National Institute on Aging's advice for older adults: aim for about three sessions of balance exercises a week (opens in a new tab), alongside aerobic and muscle-strengthening activity.

Standing on one foot, the heel-to-toe walk, walking backward or sideways, and practicing standing up from a sitting position all count as balance exercises, and so do tai chi and yoga. In the review of 108 trials, tai chi on its own may reduce the rate of falls by 19 percent. It may be a good idea to add a tai chi class alongside your other exercise.

Water is another place to practice. A review of 11 trials in adults 65 and older found that water exercise and land exercise had comparable effects on dynamic balance, which is balance while you're moving. In our warm-water pool in Wallingford, buoyancy supports your weight and decreases stress on your joints, so you can move and exercise with less pain than on land. That can make the pool a good place to work on your balance if standing exercises on land are hard on your knees or hips. The water's natural resistance also makes for gentle strength training. Our aquatic therapy programs are designed for each patient to improve function, flexibility, strength, balance and coordination.

Keep something to hold onto when you practice at home

When you try these exercises at home, practice next to a sturdy chair or a wall, or with someone beside you, so there's something to hold onto. Go slowly and carefully. If you're unsure about a movement, ask your doctor or a physical therapist before you try it. If you're helping a parent, you can be the person they hold onto.

Talk to your doctor about your balance

Balance problems can be a sign of other health problems, such as an ear infection or a stroke, so it's important to see your doctor about them.

Ask your doctor or pharmacist to go over your medicines: some can make you dizzy or confused, which makes a fall more likely (opens in a new tab), and the more you take, the higher the chance. Have your eyes and hearing tested and get your blood pressure checked lying down and standing. If you have diabetes, heart disease, or problems with your thyroid, nerves, feet or blood vessels, ask whether they could be affecting your balance.

Get medical help first for sudden unsteadiness or a fall

Call 911 right away for any of these signs of a stroke (opens in a new tab): sudden trouble walking, dizziness, loss of balance or lack of coordination, or sudden numbness or weakness in the face, arm or leg, especially on one side of the body. Sudden confusion, trouble speaking or difficulty understanding speech is on the same list. So are sudden trouble seeing and a sudden severe headache with no known cause. If the symptoms go away after a few minutes, it may have been a transient ischemic attack (TIA), which is a medical emergency too, so still call 911 right away.

After a fall, if you're hurt or can't get up on your own, ask someone for help or call 911 (opens in a new tab). If a broken hip, pelvis or upper leg is possible, call 911 and don't move the person unless it's absolutely necessary (opens in a new tab).

Falls can cause head injuries, which can be very serious, especially for someone taking certain medicines like blood thinners (opens in a new tab). If you fall and hit your head, see your doctor right away to make sure you don't have a brain injury.

After a blow to the head, whoever is with you should call 911 or take you to the emergency department right away if you have danger signs such as a headache that gets worse and does not go away, repeated vomiting, a seizure, slurred speech or confusion, or if you pass out or can't be woken up. CDC lists the rest of the danger signs (opens in a new tab).

Even if nothing hurts, contact your provider if you have fallen, or if you almost fall (opens in a new tab). While you have them on the phone, ask whether a balance program, physical therapy or both would suit you.

How to start working on your balance at Omni

There are two ways to start with us, and which one fits depends on whether your doctor has recommended physical therapy.

Without a referral, you can start with our performance and balance training program, ProPerformance, at any of our five offices: East Haven, Meriden, Milford, Wallingford and West Haven. Care is available in English and Spanish. You don't need to be an athlete. Your first session is a computerized balance evaluation, and your provider builds your plan from there, whatever your starting point.

The evaluation takes about five minutes on the ProBalance 360 and gives you a Stability Function Index, a score of your balance and coordination that becomes the baseline your progress is measured against. It's a proactive way to protect your independence, instead of waiting for a fall to force the conversation. If you'd like to know what the evaluation is like before you book, our post on balance training and fall prevention goes through it. Performance and balance training is a self-pay service and is not billed through insurance. Contact your Omni office for session pricing.

If your doctor recommends physical therapy, ours is at the Wallingford office, where our physical therapists help people move and function again after an injury, surgery or illness. Balance and fall risk are among the conditions they treat. A physical therapist can assess your balance, strength and walking ability, then build a strengthening program around what they find. Physical therapy and aquatic therapy always require a referral. If you don't have one yet, ask your physician, then call us and our staff will take care of the rest. Our chiropractic physicians can also refer you in house to our physical therapists.

To ask which path fits you, or a parent you're helping, call (203) 562-8600. If you have other questions, such as how long a session runs or when your balance is re-checked, our staff can answer them on the same call. Insurance, hours and other details are on our FAQ page.